Factors associated with clinical outcomes in patients with Coronavirus Disease 2019 in Guangzhou, China
Autor
Lei, Chunliang
Lin, Weiyin
Deng, Xilong
Hu, Fengyu
Chen, Fengjuan
Cai, Weiping
Li, Yueping
Wen, Chunyan
Guan, Yujuan
Chen, Xiaoting
Cao, Yi
Li, Feng
Tang, Xiaoping
Li, Linghua
Institución
Resumen
Background: Coronavirus Disease 2019 (COVID-19) is threatening billions of
people. We described the clinical characteristics and explore virological and
immunological factors associated with clinical outcomes.ethods: 297 COVID-19 patients hospitalized in Guangzhou Eighth People's
Hospital between January 20 and February 20, 2020 were included.
Epidemiological, clinical and laboratory data were collected and analyzed.
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) RNA in
respiratory tract, blood samples and digestive tract was detected and
lymphocyte subsets were tested periodically.
Result: Among the 297 patients (median age of 48 years), 154 (51.9%) were
female, 245 (82.5%) mild/moderate cases, and 52 (17.5%) severe/critical cases.
270 patients were detected for SARS-CoV-2 RNA in anal swabs and/or blood
samples, and the overall positive rate was 23.0% (62/270), higher in
severe/critical cases than in mild/moderate cases (52.0% vs. 16.4%, P<0.001).
The CD4/CD8 ratio on admission was significantly higher in severe/critical
cases than in mild/moderate cases (1.84 vs. 1.50, P=0.022). During a median
follow-up period of 17 days, 36 (12.1%) patients were admitted to intensive care
unit (ICU), 16 (5.4%) patients developed respiratory failure and underwent
mechanical ventilation, four (1.3%) patients needed extracorporeal membrane
oxygenation (ECMO), only one (0.34%) patients died of multiple organ failure.
Detectable SARS-CoV-2 RNA in anal swabs and/or blood samples, as well as
higher CD4/CD8 ratio were independent risk factors of respiratory failure and
ICU admission.
Conclusions: Most of COVID-19 patients in Guangzhou are mild/moderate, and
presence of extrapulmonary virus and higher CD4/CD8 ratio are associated with higher risk of worse outcomes.
Keywords: COVID-19; SARS-CoV-2; extrapulmonary virus; CD4/CD8 ratio;
respiratory failure; ICU admission